201Question
A 10-year-old child with acute post-streptococcal glomerulonephritis (APSGN) is admitted to the pediatric unit. Which finding should the nurse expect to assess during the initial evaluation?
- Polyuria and severe hypotension
- Tea-colored urine and periorbital edema
- Bright red gross hematuria and flank pain
- Epigastric pain and clay-colored stools
Show the answer and explanation
Answer: B. Tea-colored urine and periorbital edema
Topic: Acute post-streptococcal glomerulonephritis manifestations
Acute post-streptococcal glomerulonephritis is characterized by glomerular immune complex deposition leading to decreased filtration. This classically results in tea- or cola-colored urine from hematuria, along with fluid retention causing hypertension and periorbital edema.
Why the others are wrong
- A – Polyuria and hypotension are incorrect; APSGN causes fluid retention leading to oliguria and hypertension.
- C – While hematuria occurs, it is typically microscopic or gives urine a smoky, tea- or cola-colored appearance rather than bright red gross bleeding with severe flank pain.
- D – Epigastric pain and clay-colored stools point toward hepatobiliary pathology rather than glomerular disease.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
202Question
A 10-year-old child with newly diagnosed immune thrombocytopenia (ITP) has a platelet count of 18,000/uL. Which instruction should the nurse include in the discharge teaching plan for the parents?
- Encourage participation in contact sports such as tackle football to maintain normal peer interaction.
- Administer ibuprofen every 6 hours as needed for low-grade fever or mild joint discomfort.
- Provide a soft-bristled toothbrush and discourage the use of high-velocity water flossers.
- Schedule weekly intramuscular injections for routine childhood immunizations until the platelet count normalizes.
Show the answer and explanation
Answer: C. Provide a soft-bristled toothbrush and discourage the use of high-velocity water flossers.
Topic: Immune thrombocytopenia home care
Immune thrombocytopenia (ITP) is characterized by antibody-mediated destruction of platelets, increasing bleeding risk. Soft toothbrushes and avoiding invasive dental devices prevent mucosal bleeding and trauma in thrombocytopenic children.
Why the others are wrong
- A – Contact sports create a high risk of severe traumatic injury and internal hemorrhage when platelets are severely depressed.
- B – Ibuprofen and other NSAIDs impair platelet aggregation and can precipitate severe gastrointestinal or systemic bleeding.
- D – Intramuscular injections are contraindicated due to the high risk of forming large, painful muscle hematomas.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
203Question
A nurse is assessing a 4-year-old child admitted with acute Kawasaki disease who received intravenous immunoglobulin (IVIG) and high-dose aspirin therapy 24 hours ago. Which clinical finding requires immediate notification of the health care provider?
- Bilateral conjunctival injection without exudate
- A bright red, cracked oral mucosa and 'strawberry tongue'
- Crackles in bilateral lung bases and a gallop heart rhythm
- Desquamation of the skin on the fingers and toes
Show the answer and explanation
Answer: C. Crackles in bilateral lung bases and a gallop heart rhythm
Topic: Kawasaki disease complications
High-volume IVIG administration in children with Kawasaki disease can precipitate circulatory overload and heart failure, especially given the risk of coronary artery aneurysms and myocarditis. Pulmonary crackles and a gallop rhythm indicate impending or overt heart failure requiring immediate intervention.
Why the others are wrong
- A – Bilateral conjunctival injection is a standard diagnostic criterion and expected finding in acute Kawasaki disease.
- B – A 'strawberry tongue' and cracked lips are classic mucocutaneous manifestations of acute Kawasaki disease.
- D – Desquamation of the fingers and toes typically appears during the subacute phase as the acute inflammation subsides.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
204Question
An 8-month-old infant is brought to the emergency department with acute dehydration secondary to acute gastroenteritis. Which clinical manifestations should the nurse expect to assess?
Select all that apply.
- Sunken anterior fontanel
- Bounding peripheral pulses
- Tachypnea
- Decreased tear production when crying
- Tachycardia
Show the answers and explanation
Answers: A, C, D and E.
- A – Sunken anterior fontanel
- C – Tachypnea
- D – Decreased tear production when crying
- E – Tachycardia
Topic: Infant dehydration assessment
Acute dehydration in infants results in extracellular fluid volume depletion, causing compensatory tachycardia and tachypnea, reduced body secretions (tears), and physical signs of volume loss such as a sunken anterior fontanel and thready pulses.
Why the others are wrong
- B – Peripheral pulses are weak, thready, or absent in hypovolemic dehydration, not bounding.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
205Question
A 6-month-old infant with tetralogy of Fallot becomes suddenly blue and agitated while crying before a feeding. Which action should the nurse take first?
- Give a bolus of oral fluids to reduce agitation and then reassess the infant's color
- Obtain a rectal temperature and draw a complete blood count before any other intervention
- Place the infant in a knee-chest position and give supplemental oxygen
- Offer a pacifier and swaddle the infant tightly
Show the answer and explanation
Answer: C. Place the infant in a knee-chest position and give supplemental oxygen
Topic: Tetralogy of Fallot hypercyanotic spell
During a hypercyanotic spell, the knee-chest position increases systemic vascular resistance and decreases venous return, which reduces right-to-left shunting. Oxygen, calm comfort and notifying the provider follow.
Why the others are wrong
- A – Oral fluids do not treat hypoxemia and risk aspiration in a distressed infant.
- B – Assessment data are not the priority while the infant is hypoxemic.
- D – Swaddling may increase agitation and does not reverse the shunt.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
206Question
The nurse teaches the parents of a child recovering from Kawasaki disease who received intravenous immunoglobulin (IVIG). Which statements should be included?
Select all that apply.
- Follow-up is unnecessary once the fever is gone.
- Live-virus vaccines such as measles and varicella may need to be delayed for several months after IVIG.
- Antibiotics will be needed for 10 days.
- Aspirin is used in this condition even though it is usually avoided in children with viral illness.
- The skin on the fingers and toes may peel during recovery.
- Irritability may continue for some time after the fever resolves.
Show the answers and explanation
Answers: B, D, E and F.
- B – Live-virus vaccines such as measles and varicella may need to be delayed for several months after IVIG.
- D – Aspirin is used in this condition even though it is usually avoided in children with viral illness.
- E – The skin on the fingers and toes may peel during recovery.
- F – Irritability may continue for some time after the fever resolves.
Topic: Kawasaki teaching after IVIG
After IVIG, response to live-virus vaccines may be reduced, so they are delayed. Peeling of fingers and toes and irritability are expected in recovery. Aspirin is a recognized therapy in Kawasaki disease, with follow-up echocardiography needed.
Why the others are wrong
- A – Follow-up with the cardiologist and echocardiograms are needed even after the fever resolves.
- C – Antibiotics do not treat Kawasaki disease.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
207Question
A school-age child is diagnosed with acute rheumatic fever following untreated streptococcal pharyngitis. Which instruction by the nurse best helps prevent future complications?
- Avoid all physical activity permanently, including ordinary play at school
- Stop the antibiotics once the joint pain and fever have resolved and the child feels well
- Use aspirin only when a fever develops
- Take prophylactic antibiotics as prescribed to prevent recurrent streptococcal infection
Show the answer and explanation
Answer: D. Take prophylactic antibiotics as prescribed to prevent recurrent streptococcal infection
Topic: Rheumatic fever prevention
Recurrent group A streptococcal infection can cause repeated attacks and worsen valve damage. Long-term antibiotic prophylaxis is used to prevent recurrence.
Why the others are wrong
- A – Activity is restricted during the acute phase only, not permanently.
- B – Prophylaxis continues long after symptoms resolve.
- C – Aspirin addresses inflammation but does not prevent recurrence.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
208Question
A 4-year-old child is sitting upright, leaning forward with the chin thrust out, drooling, with a muffled voice and a high fever. Which action should the nurse take first?
- Inspect the throat with a tongue blade and a light to confirm that the epiglottis is swollen
- Keep the child calm and notify the provider and anesthesia so the airway can be secured
- Place the child supine for a chest assessment
- Obtain a throat culture
Show the answer and explanation
Answer: B. Keep the child calm and notify the provider and anesthesia so the airway can be secured
Topic: Epiglottitis recognition
These findings suggest epiglottitis, an airway emergency. Examining the throat or agitating the child can trigger complete obstruction. The priority is a calm child and preparation to secure the airway. Croup, in contrast, brings a barking cough after a cold and is managed supportively.
Why the others are wrong
- A – Inspecting the throat can precipitate laryngospasm and complete obstruction.
- C – Lying flat may worsen obstruction.
- D – A throat culture involves manipulating the throat and is contraindicated.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
209Question
An infant with RSV bronchiolitis has nasal congestion, a respiratory rate of 58 breaths/min, and mild retractions. Which nursing intervention is most appropriate?
- Suction the nares before feedings and give supplemental oxygen if the saturation is low
- Administer an antitussive to suppress the cough and help the infant rest between feedings
- Place the infant flat on the back with the head of the bed down to rest quietly
- Restrict all oral fluids until the cough resolves
Show the answer and explanation
Answer: A. Suction the nares before feedings and give supplemental oxygen if the saturation is low
Topic: Bronchiolitis RSV care
Bronchiolitis care is supportive: clear the nasal passages, maintain hydration, and give oxygen when needed. Cough suppressants are not recommended.
Why the others are wrong
- B – Cough suppressants are not recommended in infants and may hamper airway clearance.
- C – Flat positioning can increase respiratory effort; elevate the head.
- D – Restricting fluids risks dehydration in an infant who is breathing fast.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
210Question
A child with asthma is receiving treatment for an exacerbation. Which findings should the nurse report immediately as signs of worsening respiratory failure?
Select all that apply.
- Retractions with a falling oxygen saturation
- A respiratory rate that slows as the child becomes lethargic
- Increasing drowsiness
- Improved ability to speak in full sentences
- Decreasing wheezing with diminished breath sounds
Show the answers and explanation
Answers: A, B, C and E.
- A – Retractions with a falling oxygen saturation
- B – A respiratory rate that slows as the child becomes lethargic
- C – Increasing drowsiness
- E – Decreasing wheezing with diminished breath sounds
Topic: Asthma warning signs
Quiet chest with diminished air movement, drowsiness, falling saturation, and a slowing rate with lethargy suggest impending respiratory failure. Improved speaking suggests recovery.
Why the others are wrong
- D – Speaking in full sentences indicates improvement.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
211Question
The parent of a child with cystic fibrosis asks about nutrition. Which guidance by the nurse is most appropriate?
- Restrict dietary fat to limit greasy stools
- Limit salt intake to prevent fluid retention
- Provide a high-calorie, high-protein diet with pancreatic enzymes at meals and no salt restriction
- Give a low-calorie diet to avoid weight gain
Show the answer and explanation
Answer: C. Provide a high-calorie, high-protein diet with pancreatic enzymes at meals and no salt restriction
Topic: Cystic fibrosis diet
Malabsorption and high energy needs require high-calorie, high-protein intake with enzymes. Sweat has high sodium content, so salt is not restricted.
Why the others are wrong
- A – Fat is not restricted; enzymes are taken so fat is digested.
- B – Sodium is lost excessively in sweat, so restriction can cause depletion.
- D – Children with cystic fibrosis need more calories, not fewer.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
212Question
A 4-week-old infant has projectile, non-bilious vomiting after every feeding but is hungry again right after vomiting. Which finding should the nurse expect on assessment?
- Bile-stained green vomit after most feedings with severe abdominal pain
- A small, firm, olive-shaped mass in the right upper abdomen
- Currant jelly stools
- Abdominal distention with no stool passed since birth
Show the answer and explanation
Answer: B. A small, firm, olive-shaped mass in the right upper abdomen
Topic: Pyloric stenosis assessment
Hypertrophy of the pylorus produces non-bilious projectile vomiting and an olive-shaped palpable mass. The infant remains hungry.
Why the others are wrong
- A – Bilious vomiting suggests obstruction beyond the bile duct opening, such as malrotation.
- C – Currant jelly stool is a feature of intussusception.
- D – Delayed passage of stool with distention fits Hirschsprung disease.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
213Question
A 9-month-old infant has episodes of severe crying with the knees drawn to the chest, followed by calm periods, and passes a stool that looks like currant jelly. Which action should the nurse take first?
- Offer oral rehydration solution in small, frequent amounts to prevent dehydration
- Apply a heating pad to the abdomen
- Notify the provider promptly and keep the infant NPO
- Administer a laxative
Show the answer and explanation
Answer: C. Notify the provider promptly and keep the infant NPO
Topic: Intussusception priority
Intermittent colicky pain with currant-jelly stool suggests intussusception, which can cause bowel ischemia. The infant needs prompt evaluation and should take nothing by mouth.
Why the others are wrong
- A – Oral intake can worsen obstruction and complicate imaging or surgery.
- B – Heat may mask or worsen abdominal problems and does not treat the cause.
- D – Laxatives are contraindicated with a suspected obstruction.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
214Question
A child with Hirschsprung disease awaiting surgery is at risk for enterocolitis. Which findings should the nurse report immediately?
Select all that apply.
- Lethargy
- Abdominal distention
- Fever
- Explosive, foul-smelling diarrhea
- Passing a normal formed stool
Show the answers and explanation
Answers: A, B, C and D.
- A – Lethargy
- B – Abdominal distention
- C – Fever
- D – Explosive, foul-smelling diarrhea
Topic: Hirschsprung enterocolitis signs
Enterocolitis is a life-threatening complication with fever, foul diarrhea, distention and lethargy that can progress to sepsis and perforation.
Why the others are wrong
- E – A normal formed stool is not a warning sign.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
215Question
A parent reports that a 2-month-old infant who is gaining weight well spits up after feedings but seems comfortable. Which teaching is best?
- Place the infant prone to sleep after feedings to prevent aspiration of spit-up
- Thicken every feeding with rice cereal and add an extra feeding each night to settle the infant
- Let the infant sleep in a car seat
- Feed smaller amounts more often and hold the infant upright for 20 to 30 minutes after feeding
Show the answer and explanation
Answer: D. Feed smaller amounts more often and hold the infant upright for 20 to 30 minutes after feeding
Topic: Infant reflux teaching
For uncomplicated reflux, smaller more frequent feeds, burping and upright holding after feeds help. Infants should sleep on their back on a firm flat surface.
Why the others are wrong
- A – Prone sleeping raises the risk of sudden infant death.
- B – Thickening is not routine first-line care for every infant and extra feeds may increase spitting.
- C – Sleeping in a car seat outside travel is unsafe because of airway risk.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
216Question
A 10-year-old child with appendicitis had severe right lower quadrant pain. The child now says the pain has suddenly gone away, but the abdomen is rigid and the child has fever and tachycardia. What should the nurse suspect?
- Resolution of the inflammation because the pain has stopped on its own
- Perforation of the appendix with peritonitis
- Constipation
- Gastroenteritis
Show the answer and explanation
Answer: B. Perforation of the appendix with peritonitis
Topic: Appendicitis rupture sign
Sudden relief from pain can occur when the appendix ruptures and pressure is relieved, followed by peritonitis with rigidity, fever and tachycardia. This needs urgent reporting.
Why the others are wrong
- A – Improvement would not come with rigidity, fever and tachycardia.
- C – Constipation does not cause rigidity and signs of systemic illness.
- D – Gastroenteritis does not explain the sudden change with a rigid abdomen.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
217Question
A 2-year-old child with gastroenteritis has dry mucous membranes, sunken eyes, no tears, and has not voided in 10 hours. The child is lethargic and drinks poorly. Which prescribed action is the priority?
- Administer intravenous isotonic fluid
- Offer clear juice as tolerated, with sips every few minutes at home
- Begin a clear liquid diet at home
- Give an antidiarrheal medication
Show the answer and explanation
Answer: A. Administer intravenous isotonic fluid
Topic: Dehydration priority
These findings suggest moderate-to-severe dehydration with lethargy. Intravenous isotonic fluid restores circulating volume. Oral rehydration is first-line for mild dehydration, not for a child who is lethargic and drinking poorly.
Why the others are wrong
- B – Juice is high in sugar and can worsen diarrhea, and the child is not drinking well.
- C – Oral plans are not enough for lethargic dehydration.
- D – Antidiarrheals are not recommended in young children.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
218Question
A child with nephrotic syndrome has generalized edema. Which findings should the nurse expect?
Select all that apply.
- Low serum albumin
- Weight gain
- Massive proteinuria
- Gross hematuria with hypertension as the primary feature
- Periorbital swelling
Show the answers and explanation
Answers: A, B, C and E.
- A – Low serum albumin
- B – Weight gain
- C – Massive proteinuria
- E – Periorbital swelling
Topic: Nephrotic syndrome findings
Nephrotic syndrome causes protein loss in urine, low albumin, edema, and weight gain. Gross hematuria and hypertension are more typical of acute glomerulonephritis.
Why the others are wrong
- D – Hematuria and hypertension suggest glomerulonephritis.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
219Question
A school-age child recovering from a streptococcal skin infection develops cola-colored urine, periorbital edema and a blood pressure of 140/90 mm Hg. Which intervention is most important?
- Encourage high-sodium snacks to replace the salt lost in the urine
- Offer unlimited fluids
- Monitor blood pressure and strict intake and output
- Prepare for discharge on the day of admission
Show the answer and explanation
Answer: C. Monitor blood pressure and strict intake and output
Topic: Glomerulonephritis monitoring
Acute poststreptococcal glomerulonephritis causes hematuria, edema, hypertension and reduced urine output. Close blood pressure, weight and fluid monitoring guide treatment.
Why the others are wrong
- A – Sodium restriction is used to limit edema and hypertension.
- B – Fluids are restricted when edema and low output exist.
- D – Unstable blood pressure needs monitoring and treatment first.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
220Question
A parent of a 5-year-old girl with recurrent urinary tract infections and vesicoureteral reflux asks how to reduce recurrences. Which teaching is best?
- Limit all fluids after school to reduce how often the child needs to void
- Wipe front to back, encourage regular voiding, and give prescribed antibiotics as ordered
- Use bubble baths for hygiene
- Wait until a fever begins before calling the provider
Show the answer and explanation
Answer: B. Wipe front to back, encourage regular voiding, and give prescribed antibiotics as ordered
Topic: UTI and reflux teaching
Good perineal hygiene, regular timed voiding, adequate fluids and prescribed prophylaxis or treatment reduce the risk of recurrent infection and renal scarring.
Why the others are wrong
- A – Reducing fluids promotes stasis; fluids help flush bacteria.
- C – Bubble baths irritate the urethra.
- D – Delaying care risks kidney damage.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
221Question
A 6-year-old child with suspected bacterial meningitis arrives in the emergency department with fever, severe headache, neck stiffness and photophobia. Which action should the nurse take?
- Place the child in a semiprivate room with a roommate who has only a mild cold
- Encourage bright lights and ambulation
- Place the child on droplet precautions and prepare for antibiotics as prescribed
- Delay isolation until culture results return
Show the answer and explanation
Answer: C. Place the child on droplet precautions and prepare for antibiotics as prescribed
Topic: Meningitis isolation
Suspected bacterial meningitis requires droplet precautions until effective therapy has been given for the period the facility specifies, and prompt antibiotics. A quiet, dim environment helps comfort.
Why the others are wrong
- A – A roommate would be exposed to the infection.
- B – Bright light worsens photophobia and activity worsens headache.
- D – Isolation starts on suspicion, not after results.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
222Question
The parents of a 2-year-old whose first febrile seizure lasted two minutes ask what to do if it recurs. Which instruction is best?
- Place the child on one side, put nothing in the mouth, and time the seizure
- Hold the child's limbs firmly to stop the movements
- Place a spoon between the teeth
- Immerse the child in cold water
Show the answer and explanation
Answer: A. Place the child on one side, put nothing in the mouth, and time the seizure
Topic: Febrile seizure teaching
During a seizure, protect the airway by side-lying, never restrain or place objects in the mouth, and note the duration. Seek emergency care if it lasts more than five minutes or does not stop.
Why the others are wrong
- B – Restraint can cause injury and does not stop the seizure.
- C – Objects in the mouth can break teeth or obstruct the airway.
- D – Cold water can harm the child and does not prevent seizures.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
223Question
An infant with a ventriculoperitoneal shunt is irritable, vomiting, and has a bulging anterior fontanel and a high-pitched cry. What should the nurse do?
- Offer a pacifier to comfort the infant and recheck the findings in one hour
- Lay the infant flat with the head lowered
- Give acetaminophen and plan discharge
- Notify the provider immediately because these findings suggest shunt malfunction with increased intracranial pressure
Show the answer and explanation
Answer: D. Notify the provider immediately because these findings suggest shunt malfunction with increased intracranial pressure
Topic: VP shunt malfunction
Irritability, vomiting, bulging fontanel and high-pitched cry are signs of raised intracranial pressure from shunt blockage, a neurosurgical emergency.
Why the others are wrong
- A – Waiting delays treatment of rising pressure.
- B – Lowering the head can worsen pressure.
- C – Treating a symptom ignores the cause.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
224Question
A 7-year-old boy with Duchenne muscular dystrophy uses a wheelchair part-time. Which goal is the most appropriate for nursing care?
- Restrict all activity and keep him in bed to prevent fatigue and falls
- Promote independence and mobility as long as possible while preventing contractures and respiratory complications
- Plan only for end-of-life care
- Make decisions about his care without involving him
Show the answer and explanation
Answer: B. Promote independence and mobility as long as possible while preventing contractures and respiratory complications
Topic: Duchenne muscular dystrophy care
Care for muscular dystrophy supports function, range of motion, respiratory health and family coping. Immobility accelerates weakness and contractures.
Why the others are wrong
- A – Complete rest accelerates weakness.
- C – Support is needed across the life span, not only at the end.
- D – The child should take part in decisions at his developmental level.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
225Question
A toddler is brought in with sharply demarcated burns on both buttocks and feet in a stocking pattern. The caregiver says the child climbed into a hot bath alone. What is the nurse's best action?
- Report the findings through the mandated reporting process and document objectively
- Tell the caregiver directly that the child will be removed from the home tonight
- Discharge the child home with burn ointment and a follow-up visit only
- Leave suspicions out of the record to avoid conflict
Show the answer and explanation
Answer: A. Report the findings through the mandated reporting process and document objectively
Topic: Suspected inflicted burn
An immersion burn pattern with sharp lines and uniform depth is suspicious for inflicted injury. Nurses are mandated reporters and must report reasonable suspicion and document objectively.
Why the others are wrong
- B – Making accusations or threats is not the nurse's role and can compromise safety.
- C – Discharging without evaluation leaves the child at risk.
- D – Objective documentation is required.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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